Thirty-day readmission after medical-surgical hospitalization for people who experience imprisonment in Ontario, Canada: A retrospective cohort study
Fiona G. Kouyoumdjian aff001; Ji Yun Lee aff004; Aaron M. Orkin aff005; Stephanie Y. Cheng aff002; Kinwah Fung aff002; Tim O’Shea aff008; Gordon Guyatt aff008
Působiště autorů: Department of Family Medicine, McMaster University, Hamilton, Canada aff001; ICES, Toronto, Canada aff002; Centre for Urban Health Solutions, St. Michael’s Hospital, Toronto, Canada aff003; Faculty of Health Sciences, McMaster University, Hamilton, Canada aff004; Department of Emergency Medicine, St Joseph’s Health Centre, Unity Health, Toronto, Canada aff005; Department of Family and Community Medicine, University of Toronto, Toronto, Canada aff006; Dalla Lana School of Public Health, University of Toronto, Toronto, Canada aff007; Department of Medicine, Faculty of Medicine, McMaster University, Hamilton, Canada aff008
Vyšlo v časopise: PLoS ONE 15(1)
Kategorie: Research Article
We aimed to compare 30-day readmission after medical-surgical hospitalization for people who experience imprisonment and matched people in the general population in Ontario, Canada. We used linked population-based correctional and health administrative data. Of people released from Ontario prisons in 2010, we identified those with at least one medical or surgical hospitalization between 2005 and 2015 while they were in prison or within 6 months after release. For those with multiple eligible hospitalizations, we randomly selected one hospitalization. We stratified people by whether they were in prison or recently released from prison at the time of hospital discharge. We matched each person with a person in the general population based on age, sex, hospitalization case mix group, and hospital discharge year. Our primary outcome was 30-day hospital readmission. We included 262 hospitalizations for people in prison and 1,268 hospitalizations for people recently released from prison. Readmission rates were 7.7% (95%CI 4.4–10.9) for people in prison and 6.9% (95%CI 5.5–8.3) for people recently released from prison. Compared with matched people in the general population, the unadjusted HR was 0.72 (95%CI 0.41–1.27) for people in prison and 0.78 (95%CI 0.60–1.02) for people recently released from prison. Adjusted for baseline morbidity and social status, hospitalization characteristics, and post-discharge health care use, the HR for 30-day readmission was 0.74 (95%CI 0.40–1.37) for people in prison and 0.48 (95%CI 0.36–0.63) for people recently released from prison. In conclusion, people recently released from prison had relatively low rates of readmission. Research is needed to elucidate reasons for lower readmission to ensure care quality and access.
Critical care and emergency medicine – Hospitalizations – Hospitals – Morbidity – Ontario – Pregnancy – Primary care – Prisons
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